Podcasts about think tanks

Kiera is joined by the tooth-healer himself, Jason Dent! Jason has an extensive background in pharmacy, and shares with Kiera where his pharmaceutical experience has bled over into dentistry. This includes the difference between anti-quag and anti-platelet and which medications are probably safe, what to do to shorten the drag time in the pharmacy, how to write prescriptions most efficiently, and more. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:00) Hello, Dental A Team listeners. This is Kiera and today is a really awesome and unique day. It is, think the second time I've had somebody in the podcast studio with me live for a podcast and it's the one and only Jason Dent. Jason, how are you? I'm doing well. Good morning. Thanks for having me. It is crazy. I I watch Instagram real like this all the time where people are like in the podcast and they're hanging out on two chairs and couches and now look at us. We're doing it. Cheers. Cheers.   That was a mic cheer for those of you who are only listening, but yeah, Jace, how does this feel to be on the podcast? It's weird. Like I was not nervous at all talking about it. I got really nervous as soon as you hit play. So if I stumble over my words, please forgive me ahead of time. Well, Jason, I appreciate you being on the podcast because marketing had asked me to do a topic about teledentistry and I was like, oh shoot, that's like not my forte at all. so   You and I were actually chatting in the hot tub. call it Think Tank session and you and I, we have a lot of good ideas that come from that Think Tank. A lot of business. no phones. That's why. We do leave our phones out. But I was talking to Jason and this is actually a podcast we had talked about quite a while ago. Jason has a lot of information on pharmacy. And if you don't know, Jason isn't really, we were going through all of it last night. It's kind of a mock in the tub. And I think it's going to be great because I feel like this is an area, I'm working at Midwestern and   knowing about how dentists, pharmacology was surely not your favorite one. Jason actually helps a lot of dentists with their clearances. And so we were talking about it and I like it will just be a really awesome podcast for you guys to brush up on pharmacology, different things from a pharmacist's side. So Jason, welcome. Thank you. Yeah, no, we were talking about it and here's like, what should I talk about on the podcast next? I have all these different topics and she's like, what do you know? And the only real interaction I have with dentists is doing clearances for procedures. We get them all the time, which makes sense.   Lots of people are on blood thinner, I've always told Kiera, like, hey, I could talk about that. Like, that's kind of a passion of mine. I'm not a dentist. Or my name is Jason Dent. So in Hebrew, Jason means tooth. No, no, no, sorry. Nerves are getting to me. Jason means healer and Dent means tooth. So my name means tooth healer. So, here's a little set. Hold on, on, hold Can we just talk about? I brought that up before you could talk about it more. So.   My name means tooth healer but I did not become a dentist. I know you wanted me to become a dentist. did. I don't know why. I enjoy medicine. I know what you're going to get to already. The things you're going to ask me. There's been years of this. But nevertheless, that's my name. We'll get that out of the way. But you did give me a great last name. So I mean, it's OK. You're All is fair and love here. SEO's up for that. But yeah, Jason, I'm going to get you right into the show. And I'm going to be the host. And we're going to welcome to the podcast show. Jace, how are you?   Good, good, good. Good, good, good. So by getting into clearances, right? This is what you're kinda talking about with you know, before we get to clearances, I actually wanted Jason, for the listeners who don't know you, who haven't talked to you, who don't know, let's kinda just give them like, how did you go from, Kiera wanted you to be a dentist, to now Jason, you are on the podcast talking as our expert on pharmacy. fantastic. I've always really loved medicine, a ton. As a kid getting headaches and taking Excedrin, like you just feel like a miserable pile of crap.   and then you take two pills and all of a sudden you feel better. Like that's amazing, like how does that happen? Also getting ear aches as a kid, just being in so much pain and then taking some medicine and you start feeling a lot better. I always had a lot of appreciation for that. I've always been mechanically inclined. I went to, started doing my undergrad and took biology and learned about ATP synthase, which is a spinning enzyme that's inside the mitochondria, like a turbine engine. I used to work on small engines on my dirt bike and thought that is so cool. So I really got wrapped up into chemistry.   All the mechanics of chemistry really pulled me in. I'm not getting goosebumps. checking. I usually get goosebumps when I think about chemistry. But it's so cool. You think an engine's awesome, like pistons and camshafts and pressures, the cell is the same thing. It's not as loud, so it's not as cool. But it's fascinating. that's why we're like. ⁓   chemistry and really got into coagulation. So I did my residency after pharmacy school. we went to Arizona for three years. ⁓ You did and your main focus, you were never wanting to be the guy behind the counter. No, I haven't done that. Yeah. No, I love them though. I've always really want to go clinical. ⁓ But I love my retail ⁓ pharmacists. They're amazing resources. And ⁓ I use the retail pharmacist every day still to this day, but I went more the clinical route, really love the chemistry aspect of it.   did my doctorate degree and then I did my residency in Reno. Reno's kind That's how we got here everybody. Welcome to Reno. Strategically placed because I was really interested in critical medicine and where we're located we cover a huge area. So we pull in to almost clear, we go clear to Utah, clear to California, all of Northern Nevada. We get cases from all over. So we actually are kind like the first hub of care for lot of areas. So we really get an eclectic mixture of patients that come in that need-   all kinds of different cases that are coming to them. So it's what I really wanted. So I did my residency in critical care there. And then for the next 10 years, I worked in vascular medicine with my final five years being the supervisor of the clinic. Ran all the ins and outs of that. So my providers, two doctors were on our view. So when we talk about dentistry, talk about production, those kinds of things, totally get it. My doctors were the exact same way, my vascular providers. ⁓   There's some pains there, right? You wanna be seeing patients as much as possible, being able to help as many people, keeping the billing up. And had other nurse practitioners, four practitioners, a fleet of MAs, eight pharmacists. We also had that one location we had, going off the top of my head, I think we had eight locations running as well. And we took care of all the different kinds of vascular cases that came to us. Most common was blood clots, ⁓ which is just a...   which is an easier way of saying VTE. There's so many different ways to say a blood clot. Like you might hear patients say, I've had a PE or a DVT or a venous thromboembolism or a clot in my leg, right? They're all clots, but in different locations. Same with an MI, and MI can be a clot as well. ⁓ there's a lot of, everybody's kind of saying the same thing, but sometimes the nomenclature can make it sound hard, but it really is actually pretty simple.   No. And Jason, I love that you went through, you've been in like, and even in your, ⁓ when you were getting your doctorate, you were in the ER. You also worked in retail pharmacy. remember you having a little sticker on your hand. And retail pharmacy, I have a lot of respect for those guys. They have a lot of pressure on them. and then you also, ⁓ what was that test that you had to take that? I don't know. You were like studying forever for it. ⁓ board certification for, ⁓ NABP. Yeah. So I did that board certification as well.   And now you've moved out of the hospital side onto another section in your career. Now in the insurance, right? So it's really, really interesting. So now I'm on the other side reading notes and evaluating clinical appropriateness and trying to help patients with getting coverage and making those kinds of determinations. So yeah, I've really jumped all over. Really love my clinical days. I know. don't I don't I do miss them. But yeah, kind of had a good exposure to a lot of.   pharmacy a lot a lot of dentists actually with all the places that come through which Jason I really appreciate that and honestly I know you are my spouse and so it's fun to have you on but when I go into conversations like this I don't know any of this information and so finding experts and Jason I think here's me talk more about dentistry and my business than I do hear about him on pharmacy so as we were chatting about this I really realized you are a wealth of knowledge because you've been on the clinical side so you've done a lot of patient care and you've seen how   medications interact and I know you've had a few scares in your career and ⁓ you've known some physicians that have had a few scares and ⁓ you've seen plenty of patients pass away working in the ER and gosh in Arizona drownings were such a big deal. I remember when you were in the ER on your rotations I'd be like who died today? Like tell me the stories and you've really seen and now going on to the insurance side I felt like you could just be such a good wealth of knowledge because I know dentists are sometimes so   I would say like maybe just a little more anxious when it comes to medications. I know that dental students from Midwestern were like here was like four months and we had to like pass it, learn it. And Jason, you've done four years plus clinical residency, plus you've been in it. And something I really love about Nevada Medicine is they've been so collaborative with you.   like your heart, your cardiologist, they diagnose and then they send to you to treat with medicine and... Yeah, I've been really lucky being here in Reno too. The cardiology team has been amazing to work with. We started a CHF program, sorry, congestive heart failure program for patients. So we would collaborate with cardiologists. They'd see the cardiologists and then they send them to the pharmacist to really manage all the medications. So there's pillars of therapy ⁓ called guideline directed medical therapy and the pharmacist would take care of all that. So that's gonna be your...   your beta blockers, your ACEs, your ARBs, your Entresto, which would be a little bit better, spironolactone. So just making sure that all these things are dosed appropriately, really monitoring the heart, and make sure that patients are getting better. we've had real positive outcomes when the, sorry, this is totally off topic. do, talk about that study. When we looked at when patients were coming to see our pharmacists in our clinic that we started up, the patients were half as likely to be readmitted. And this was in 2018, and our pharmacists,   We're thinking about all the medications. We're usually adjusting diabetes medications too at the same time. Just kind of naturally just taking care of all the medications because we kind of got a go ahead from the providers, a collaborative practice agreement that we could make adjustments to certain medications within certain parameters. So we weren't going rogue or maverick, but we were definitely trying to optimize our medications as much as possible. And then years later, some studies came out with, I'm sure you've seen Jardins and Farseegh. not trying to, I'm not.   I don't get any kickback from them. I have no conflicts to share. But because our pharmacists were really optimizing that medication, those medications were later shown to reduce hospitalizations and heart failure, even though they're diabetes medications. Fascinating. So it wasn't really the pharmacists. It was just the pharmacists doing as much as they can with all the tools that were in front of them. And then we found out that the patients were going back to the hospital.   half as much as regular patients. So, yeah, being here, it's been so amazing to work with providers here. the providers here want help, want to help patients, don't have an ego. I mean, I just, it's awesome. I love it. I do love how much I think Jason sees me geek out about dentistry and I watching Jay's geek about his pharmacy and how much he loves helping patients. And ⁓ really that was the whole idea of, all right.   Dentistry has pharmacy as a part of it. And I know a lot of dentists are sending in clearances and I know working in a chair side, it would be like, oh no, if they're on warfarin or on their own blood clot, you guys, honestly don't even know half of what I'm talking about because this is not my jam, which is why Jason's here. But I do know that there was always like, well, we got to talk with their provider. And so having Jason come in and just kind of explain being the pharmacist that is approving or denying or saying yes or no to take them off the blood thinners in different parts, because you have seen several dental   I don't know what they're called. What is it? Clarence's? that what comes to you? don't even know. All day my mind, it's like, here is the piece of paper that gets mailed to you to the pharmacist and then you mail it back. So whatever that is. But Chase, let's talk about it because I think you can give the dentist a lot of confidence coming from a pharmacist. What you guys see on that side. When do you actually need to approve or disapprove? Let's kind of dig into that. Yeah. Well, first of all, I think I'm not a replacement for any kind of clinical judgment whatsoever. Every patient's different. But the American Diabetes Association, you   I work with diabetes a lot. American Dental Association has some really great guidelines on blood thinners and I would always reference them. I actually looked at their website today. Make sure I'm up to speed before I get back on this again. They have resources all around making decisions for blood thinners. And I think the one real important thing in putting myself in the shoes of a dentist or any kind of staff that's around a patient that's in a chair, if they say I'm on a blood thinner, right, a flag goes up. At least in my mind, that's what goes up.   Like, okay, how do we get across this bridge? And I think the important thing to really distinct right then when they say they're on a blood thinner is that is kind of a slang word for a lot of different medications, right? Like it's the overarching word that everybody pulls up saying, I'm on a blood thinner. It's like, okay, but I don't know what say. It's like, I have a car. You're like, okay, do you have a Mazda? Do you have?   Toyota, Honda, what do you have? or even worse it'd be like saying I have a vehicle, right? So when somebody says they're on a blood thinner, it opens up a whole box of possibilities of what they're Blood thinners are also, doesn't, when they're taking these types of medications that are quote unquote a blood thinner, it doesn't actually thin the blood, like adding water to the blood, if that makes sense, or like thinning paint, or like thinning out a gravy, right? It doesn't do the same thing. Blood thinners, really what they're doing is they're working on the blood, which.   which is really cool, try not to tangent on that. ⁓ When they're working on the blood, it's not thinning it per se, but it's making it so that the proteins or platelets that are in it can't stick together and make a cloth quite as easy. So whenever somebody's on a blood thinner, I usually ask, what's the name of the blood thinner that you're on? It's not bad that they use that slang, that's okay, on the same page, but it's really broken into two different classes. There's anticoagulant and antiplatelet.   And a way to kind of remember which is which, when residents would come through our clinics, the way that I teach them is a clot is like a brick wall. You know, it's not always a brick wall. Usually the blood is a liquid going through. But once they receive some kind of chemical message, it starts making a brick wall with the mortar, which is the concrete between the and the bricks, the two parts. When it's an anti-quagent, it's working on that mortar part. When it's an anti-platelet, it's working on the bricks part, right? You need both to make a strong clot or strong brick wall.   But if you can make one of them not work, obviously like if your mortar is just water, it's not working, right? You're not gonna make a strong brick wall. So that's kind of the two deviants right there. So that's what I do in my mind real quickly to find out because antiplatelets are usually, so that's gonna be like your Plavix, Ticagrelor, Brilinta. And hold on, antiplatelets are bricks? Good job, bricks. They're the bricks. And so the reason I was thinking you could remember this because I'm, antiplatelets, it's a plate and a plate is more like a brick.   And anti coagulant, I don't know why quag feels like mortar to me, like quag, like, know, it's like slushy in the blood, like it's coagulating. It's a little bit of that, like, honestly, I'm just thinking like coagulated blood is a little bit more mortar-ish. And so platelet is your plate, like a brick, and anti-quag is like.   the gilly between the bricks. Okay, okay, I got it. Yeah, so there's an exception to every rule, but when they're on that Don't worry, this is Kiera, just like very basic. You guys are way smarter listening to this, and that's why Jason's here. No, no, you helped me pass pharmacy school. When we were doing all the top 200, you helped me memorize all know what flexorill is, all right? That's a muscle relaxant. Cyclo? I don't know that part. It's a cyclo, because you guys are cycling and flexing. I don't actually know. just know it's a muscle relaxant, so that's about as far as I got. When we're looking at antitick platelets, so that's the brick part, so that's going to be your, you know,   Hecagrelor, Breitlingta, Clopidogrel is the most common one. It's the cheapest one, so probably see that one the most. Those, I mean, there's an exception to every rule, but that's generally being used after like a stent's placed in the heart. It can be used for VTE, there's some out there, but that's pretty rare. But also for some valves that are placed in the hearts, it can be used for that as well. So antiplatelet, really thinking more like a cardiac event, right? Like I said, there's always an exception to every rule, but that's kind of where my mind goes real quickly, because we're gathering information from the patient.   They're on anticoagulant. Those are like going to be the new ones that you see commercials for all the time. So Xeralto, Alequis, those are the two big ones right now. They're replacing the older one. And also we were supposed to do a disclaimer of this is current as of today because the ADA guidelines do change. this will be current as of today. And Jason, as a pharmacist, is always looking up on that. I had no clue that you are that up to speed on dental knowledge. so just throwing it out there that if you happen to catch his podcast,   a few years back that obviously check those guidelines for sure. But the new ones are the Xarelto and Eloquist. They're replacing the older ones of warfarin. Warfarin's been around for a really long time. We've seen that one. Those are anti-coagulants. So when you're looking, when a patient says that, generally they're on that medication because they've possibly had a clot in the past or they have a heart condition called atrial fibrillation. Those are kind of the two big ones. Like I said, there's always caveats to it, but that's kind of where my mind goes real quickly. And then,   as far as getting patients cleared, the American Dental Association has really good resources on their website. You can look at those and they're always refreshing that up. They even say in their own words that there's limited data around studying patients in the dental chair and with anticoagulants or anti-platelets. It's pretty limited. There's a few studies, some from 2015, some from 2018. There's one as recent as 2021, which is nice. But really, all of those studies come together and it's really more of an expert consensus.   And with that expert consensus, they have kind of simplified things for dentistry, which is really nice. ⁓ comparing that to, we have more data for like total hip replacement, total knee replacement. We have a lot of data and we know really what we should be doing around then. But going back to dentistry, we don't have as much information, so they always say use clinical judgment, but they do give some really great expert guidance on that. So if a patient's on an anticoagulant, ⁓   they generally recommend that it doesn't need to be stopped unless there's a high bleeding risk for a patient. as a provider or as a clinician in the practice, you can be looking at high bleeding risk. Some things that make an oral procedure a little bit lower risk is one, it's in the compressible site, right? Like we can actually put pressure on that site. That's the number one way to stop bleeding is adding pressure. It's not like it's in the abdominal cavity where we can't get in and can't apply pressure. So number one, that kind of reduces the bleeding risk.   is number one. Two, we can add topical hemostatic agents. Dentists would know that better than me. There's a lot of topical ways to do that. So not only pressure, but there's those things as well. And also, but there are some procedures that are a little bit more likely to bleed. And that's where you and dentists would come in hand in What's the word in APO? Oh, the APOectomy. I got it right. Good job. like, didn't you tell me last night that the ADA guideline was like what?   three or four or more teeth? great question. So you can extract one to three teeth is what their expert consensus One to three teeth without. Without really managing or stopping anticoagulation or doing anything like that. I think that's some good guidance from them. I'm gonna add a Jasonism on that though. So with warfarin, I do see why dentists would be a little bit more conservative or worried about stopping the warfarin because warfarin isn't as stable as these newer agents. Warfarin, the levels.   quote unquote levels can go really high, they can go really low. And if the warfarin levels are high, they're more likely to bleed. So I do think it makes sense to have a really recent INR. That's how we measure what the warfarin's doing. I think that makes a lot of sense, but the ADA guidelines really go into the simplification version of all these blood thinners. Generally, it's recommended to not stop them because the risk of stopping them outweighs the benefit of stopping them in almost every case. Almost every case.   ⁓ So when you're with that patient, right, they say I'm on a blood thinner, finding out which kind of blood thinner that they're on, you find out that they're on Xeralto, right? How long have you been on Xeralto for? I've been on it for years. You don't know exactly why, but if they haven't had any recent bleeding, you're only gonna remove one tooth. ⁓ You can do what's called a HasBlood score. That kind of looks at the bleeding risk that they'd have. That'd be kind of going a notch above, but in my mind, removing one tooth isn't a real serious bleeding risk. I'd love to hear from my dentist friends if they...   disagree, right, but ADA says one to three tooth removals, extractions, that's the fancy word. Extractions, yeah, for extracting teeth out. Is not really that invasive. Sure. It's not that high risk, so it's usually perfectly fine. So if a patient was on Xarelto, ⁓ no other, this is in a vacuum, right? I'm not looking at any other factors, which you should be looking at other factors. I would be perfectly fine to just remove one to two.   And when those clearances come in, because dentists do send them, talk about what happens. You guys were working in the hospital and you guys would get these clearances all the time. do. We get them so often. I mean, we get like four or five a day. We'd love to give it to our students, student pharmacists, and ask them what to do. And they would usually look up the American Dental Association guidelines and come up with something. We're like, yep, that's what we say too. In fact, we say it so many times a day that we have a smart phrase.   which just blows in the information real quickly and faxes it right back to the So it's like a copy paste real quick. So what I wanted to point out when Jason told me this is dentists like hearing this and learning this, this can actually save you guys a ton of time to be able to be more confident, to not need to send those clearances on. And we were actually talking last night about how I think this might be a CYA for dentists. like, as we were talking, I think Jason, you seeing so many other aspects of medicine, like you've literally seen patients die, you've seen other areas.   And so coming from that clinical vantage point, we were realizing that dentists, we are so blessed to live in an injury. I enjoy dentistry because possibly there's someone dying, not super high, luckily in dentistry. The only time that I have actually had a doctor have a patient pass away, and it was only when they were completely sedated and doing ⁓ some other things, but that was under the care of an anesthesiologist. And so that's really our high, high risk. And so hearing this, Jason,   That was one of the reasons I wanted him to come on is to give you doctors more confidence of do we have to always send to a pharmacist? I mean, hearing that on the pharmacy side, they're just sending these back and not to say to not see why a to not cover this because you might be questioning like, well, do I really need to? But you also were talking about some other ways of so number one, you guys are just going to copy back the 88 guidelines. So so 88 guidelines. Yeah. And I think that that gives a lot of confidence to a provider or a dentist is that you can go to the 88 guidelines and read them, right? Like you're listening to some   nasally monotone pharmacist on a podcast. Rumor has it, people love him at the hospital. were like, you're the voice, he's been told he has a good radio So for the clinic, I was the voice. Like, yeah, you've reached the vascular clinic, right? And they're like, oh my gosh, you're the voice. But sorry, you me distracted. That'll be your next career, Jace. You're going to be a radio host. OK. I would love that. I love music. But you're hearing from a nasally guy, but you can actually read the ADA guidelines. You just go right to the ADA, click on Resources, and under Resources, it has the   around anticoagulants, I think that's the best way to get a lot of confidence about it because they have dentists who are the experts making calls on these. I'm just reiterating what they say, but I think it makes a lot of sense to help providers. And the reason why my heart goes out to you as well is having the providers that used to work underneath me, they're always looking for our views, which is a fancy way of making sure that they're drilling and filling. Can I say that? Yeah, can say drilling and filling. They're being productive, right? They're being productive, right?   They're always looking to make sure if a patient's canceling, like get somebody in here. Like I need to be helping people all day long. That's how I, we keep the lights on. That's how I help as many people. And so if you have a patient coming in the chair and it has an issue, they say I'm on Xeralto. Well, you can ask real quickly, why are you on Xeralto? I had a clot 10 years ago. my gosh. Well, yeah, we're pretty good to go. Then I'm not worried. We're only removing one tooth or we're just doing a cavity or a cleaning. Something like that. Shouldn't be an issue whatsoever because there's experts in the dental. ⁓   in the dental society, the ADA guidelines that recommend three teeth or less, minimally invasive. They really recommend if it's gonna be really high bleeding risk. And clinically, that's where you would come in, ⁓ or yourself. know, apioectomy is one that's like on the fence line. I don't know where implants set. though, and like we were talking, implants aren't usually like a date of procedure. Most people aren't popping in, having tooth pain, and we're like, let's do an implant. Now sometimes that can be the case, but typically that one's gonna have   a few other pieces involved. And so that is where you can get a clearance if you want to. ⁓ But we were really looking at this of like so many dentists that I know that you've seen will just send in these clearances because they are. And I think maybe a way to help dentists have more confidence is because you know, I love routines. I love to not have to remember things. So why don't we throw it in, have the team member set it up where every quarter we just double check the ADA guidelines. Are there any updates? Are there any other things that we need to do on that? That way you can just see like   getting into the language of this, of what do I need to do? Because honestly, you guys, know pharmacy was not a big portion for it, so, recommending different parts, but I think this is such a space where you can have confidence, and there's a few other things I wanna get to, and I you- I some pearls too. Okay, go. I'm so when she get me into talking about drugs, I'm not gonna stop. So, some other things around that too is these newer blood thinners like Xarelto Eloquist, they now have reversal agents, so a lot of providers in the past were really worried about bleeding because we can't turn it off. We can turn those off. Warfarin has reversal as well, right?   So I'm looking at these patients. It's really low risk. It's in the mouth, generally speaking. Very rarely are they a high bleeding risk. Now if you're doing maxillofacial surgery, this does not apply, right? This does not apply whatsoever. you're like general dentist, you're pediatric dentist. Yeah, yeah, and it's kind of on the fly. So just trying to really help you to be able to take care of those patients on the moment, have that confidence, look at the ADA guidelines, have that in front of you. I don't think it's a bad thing to ever...   check with their provider if you need to. If you're thinking, I feel like I should just check with the provider, I would never take that away from you. But I just want to kind of steer towards those guidelines that I have to help. But what did you want to share? No, yeah, I love that. And I think there were just a few other nuggets that we were chatting about last night that can help dentists just kind of get things passed a little bit easier. So you were mentioning that if they were named to their cardiologist, what was it? was like, who is the last? Great question. Yeah, when a patient's on a blood thinner,   It could be prescribed by the cardiologist. It could be prescribed by the family provider or could have been punted to like a vascular clinic like where I was working. It can go to any of those. And when you send that fax, right, if it goes to the cardiologist and it's supposed to go to the family care provider, like it just kind of goes, goes nowhere, right, from there. So I think it's a really good idea to find out who prescribed it last. If the patient doesn't know who prescribed their blood thinner last, you can call their pharmacy. I call pharmacies all day long.   I have noticed in the last year, they are way easier to get a hold of, which has made my job a lot easier, working on the insurance portion. So reaching out to the pharmacy, finding out who that provider is and sending it to them, because they should be able to help with that. I thought that was a good shift in verbiage that you had of asking instead of like the cardiologist, because that's who you would assume was the one. But you said like so many times you guys would take care of them, and then they go back to family practitioner, and you guys would get the clearances, but you couldn't clear because you weren't overseeing. So just asking the patient.   who prescribed their medication for them last time. That way you can send the clearance to the correct provider. then- And they might not know. You know patients, right? They're like, I don't know, my mom's or else, I don't know who gave it to me. Somebody told me I need to be on this. But at least that could be another quick thing. And then also we were talking last night about-   ⁓ What are some other things that dentists can do when like writing scripts to help them get what I think like overarching theme of everything we discussed is one how to help dentists have less I think drag through pharmacy. ⁓ Because pharmacy can take a little while and so perfect we now know the difference between anti-quag and anti-platelet. We know which medications are probably safe. We know we can check the ADA guidelines so that we were not having to do as many clearances. We also know if they're on a medication to find out and we do need a clearance.   who we can go to for the fastest, easiest result. And now, in talking about prescriptions, you had some really interesting tips that you could share with them. Yeah, so with writing prescriptions, right, pharmacies are pharmacies. So I'm not gonna say good thing or bad thing. There are challenges working with pharmacies. I'm not gonna play that down at all. ⁓ If you're writing prescriptions and having issues and kickbacks from pharmacies, there's some interesting laws around ⁓ writing prescriptions. Say that you're trying to ⁓ prescribe   augmentin, you know, 875 BID, and you tell the patient, hey, I want you to take this twice a day for seven days, and then you put quantity of seven, because you're moving fast, right? You want it for seven days, quantity of seven. Quantity would actually be 14, right? It's not that big of a deal. Anybody with common sense would say if you're taking a pill for twice a day for seven days, you need 14 tablets. But LAHA doesn't allow pharmacists to make that kind of a change, unfortunately. They have to follow what you're saying there. So you're going to get a...   An annoying callback that says, you wrote for seven tablets. I know you need 14. Is that OK? Just delays things, right? So ⁓ I really like the two letters QS. That's Q isn't queen. S isn't Sam. Yeah. It stands for quantity sufficient. So you don't have to calculate the amount of any medication that you're doing. So for me, as a pharmacist, when I was taking care of patients, I hated calculating the amount of insulin they would need for an entire month. So I would say.   Mrs. Jones needs 15, I'd say 15 units ⁓ QD daily. ⁓ And then I say QS, quantity sufficient, ⁓ 90 day supply through refills. So the pharmacy can then go calculate how much insulin that they need. I don't have to even do that. So anytime you're prescribing anything, I like that QS personally. So that lets the pharmacy use ⁓ common sense, as I like to call it, instead of giving you a call. I think that's super helpful. I also thought of one thing too.   going back to blood thinners is when it's kind of like a real quick, like they're not gonna have you stop the blood thinner at all. like you're seeing if you can stop the blood thinner for a patient, there's some instances it's just not gonna happen. And that's whenever they've been, they've had a clot or a stroke or a heart attack within the last three months. Three months. Yeah, that's kind of like the.   Because so many people are like, they had a heart thing like six years ago. And so I think a lot of my dentists that I worked with were like, we got to stop the blood thinners. But it sounds like it's within three months. Yeah, well, I'm just the time. Like this is general broad strokes. What I'm just trying to say is when you want to expect a no real quick. Got it. Right. So because benefits of stopping a blood thinner within those first three months of an event is very, very risky versus the, you know, the benefit of reducing a little bit of blood coming out of the mouth. Right. Like that's not that bad.   when somebody's had a stroke or a heart attack or pulmonary embolism, a clot in the lung, like we can't replace the lung, heart or brain very easily. We can replace blood a lot better. We've got buckets of it at most hospitals have buckets of it, right? So I'm always kind of leaning towards I'd rather replace blood than tissue at all times. So that's kind of a quick no. If they've had one those events in the last three months, we are really, really gonna watch their brain instead of getting.   root canal, right? Like really worried about them. So you'll just say no. And they could the dentist still proceed with the procedure or would you recommend like a three month wait? Or is it provider specific way the pros and cons because sometimes you need to get that tooth out. Great question. think then it's going to come into clinical. That's that's when you send in the clearance, right? Like, and it's great to reach out to the provider who's managing it for you. But I think it's kind of good to know exactly when you get a quick no quick no is going to be less than three months.   ⁓ Or when it's going to be like a kind of a typical, yeah, no problem. If it's been no greater than six months, they're on the typical anticoagulants or alto eloquence. Nothing crazy is going on for them. You're only removing two teeth. This is very, very low risk. But again, I'd urge everybody to read the ADA guidelines. That way you feel more comfortable with it. I'm not as eloquent as they do. They do a real good job. So I don't want to take any of their credit. I think they do a real good job of simplifying that and making you feel confident with providing.   more timely care for patients. Which is amazing. And Jayce, one last thing. I don't remember what it was. You were talking about the DEA and like six month rule. yeah. Let's just quickly talk about that and then we'll wrap this because this is such a fascinating thing for me last night. Yeah. So when comes to prescribing controlled substances, most providers have to have a DEA license. OK. First of all, though, what's your take on dentist prescribing controlled substances? ⁓ I don't think, you know, I worked on the insurance side of things. Right. And I look at the requirements for the   as the authorizations, what a patient, the criteria a patient needs to hit in order to qualify for certain medications. A lot of times for those controlled substances, they have pretty significant issues going on, like fibromyalgia or cancer-related pain or end-of-life care versus we don't, in all my scanning thread, I don't have a ⁓ perfect picture memory. Sure. But I don't usually see oral.   pain in there. There is some post-operative pain that can be covered for those kind of medications but I really recommend to keep those lower and in fact in a lot of our criteria it recommends you know have they tried Tylenol first, they tried, have they filled NSAIDs or are they contraindicated with the patient. So really they should be last line for patients in my two cents but there's always going to be a caveat to the rule right? Of course. comes through that has oral cancer and you're taking   like that would make sense to me. Got it, so then back to the DEA. Yeah, okay. Okay, ready. So as a provider, you should be checking the, if you're doing controlled substances, you should be checking the prescription drug monitoring program, or sometimes called the PDMP, looking to see if patients are getting ⁓ controlled substances from another provider. So it's really just a check and balance to make sure that they're not going from provider to provider to getting too many narcotics and causing self harm or harm to others.   And so with checking that PDMP before prescribing, I think a lot of providers do that. A lot of softwares that I'm aware of, EMRs, electronic medical records, sometimes have links so that you can do that more quickly. However, I don't think it's as intuitive that they need to be checking that every six months in some states. And like here in Nevada, you're supposed to be checking it every six months, not for a patient, but for your actual DEA registration to see if anybody else is prescribing underneath you. Because if you don't check that every six months, you could get in some serious trouble with...   not only DEA, but even more the Board of Pharmacy and your state. Now, I don't know all 50 states, so I check with your state to see if you need to be checking that every six months, but set an alarm just to check that real quickly, keep your nose clean. ⁓ I've had providers, I've had to remind to do that. And if somebody was using your account, prescribing narcotics, you'd never know unless you went and checked that PDMP.   Yeah, I remember last night you were like, and if that was you, I would not want to be you. The Board of Pharmacy is going to be real excited to find you. So that was something where I was like, got it. So, and we all know I'm big on let's make it easy. And Jason, I love that you love this so much and you just brought so much value today. And like also for me, it's just fun to podcast. fun. Yeah. But I got a nerd out on my world a little bit. Bring it into yours. I work with dentists or at least you know, when I was working in Vascular Clinic all day long. Great questions that would come through. Yeah.   So I think for all of us, as a recap on this is number one, I think setting yourself ⁓ some cadences. So maybe every quarter we check our ADA guidelines and we check our, what is it, PDMP. PDMP. so each state, so they call it Prescription Drug Monitoring Program. We need that. Yeah, but there are different acronyms in different states, though. That's just what it's called in Nevada. I forget what it is in California, but you can check your state's prescription monitoring program, make sure that opioids aren't being prescribed under your name. Got it. So we just set that as a cadence.   We know one to three teeth most likely if they're on a blood thinner is According to the 88 as of today is good to go You know things that are going to get a quick know are going to be within the last three months of the stroke the heart attack or the Clot I'm thinking like the pulmonary embolus. Yeah, that's what we're trying to prevent   Those are gonna be quick knows and then if we're prescribing, let's do QS. We've got quantity is sufficient so that we're not getting phone calls back on those medications that we are. And then on narcotics, just being a bit more cautious. Of course, this is provider specific and in no way, or form did Jason come on here to tell you you are the clinical expert.   Jason's the clinical expert on medications. And if you guys ever have questions, I know Jason, you geek out and you want to talk to people so that anyone wants to chat shop. Be sure to reach out and we'll be able to connect you in. we've even talked about possibly, so let me know listeners. You can email in Hello@TheDentalATeam.com of ask a pharmacist anything. I talked to Jason. I was like,   We'll just have them like send in questions and maybe get you back on the podcast or we do a webinar. But any last thoughts, Jace, you've got of pharmacy and dentistry as we as we wrap up today? No, I think that's pretty much it. So check the ADA guidelines. I think it's really good to have cross communication between professions. Right. If you're working with the pharmacy, CVS, Walgreens or something like that or Walmart, I know that it can be challenging. Right. They're under different pressures. You're under different pressure. So I think ⁓ just coming in with an understanding, not being angry at each other.   you know what mean, is super beneficial and working together. When it comes to it, every dentist that I've talked to is actually worried about their patient. Every pharmacist that I've worked with is really worried about the patient as well. So we're trying to accomplish the same thing, but we have different rules and our hands are bound in different ways that annoy each other, right? Like I know Dr. Jones, want 14 tablets, but you said seven. And I know Common Sense says I should give them 14, but I've got to make that change.   knowing that their hands are tied by the law. They can't use as much common sense, which is aggravating. I mean, that's why I love what I gotta do here. I gotta just kind of help a lot more and use common sense and improve patient care. But those kinds of things I think are really beneficial as you work together and then not being so afraid of blood thinners, right? So I think those guidelines do a great job of giving you confidence and not worrying about the side effects. And there's a lot of things that you can do locally for bleeding.   You have a lot of control over that. I think that's pretty cool, the tools they have. Yeah. And at the end of the day, yes, you are the clinician. You are the one who is responsible for this. so obviously, chat, but I think collaborating, talking to other pharmacists, talking to them in your state, finding out what are the state laws, things like that I think can be really beneficial just to give you peace of mind and confidence. And again, dentistry, are maybe a bit more risk adverse because luckily we don't have patients dying That's great thing. Yeah, that's fantastic. I want my dentists to be risk adverse. I think so too. But Jason, I appreciate you being on the podcast today.   And for all of you listening, ⁓ more confidence, more clarity, more streamline to be able to serve and help our patients better. if we can help you in any way or you've got more questions, reach out Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.  

Rex Miller is a keynote speaker, futurist, and executive coach who helps leaders and organizations unlock the hidden genius that lies just beneath the surface, often trapped by outdated systems, fear, or inertia. He is author of the book, "Genius Spark: Reignite Your Life" and Mike Petrusky references insights learned from Rex over the years as they discuss the challenges of remote and hybrid work today. They explore how workplace leaders should embrace differences and friction in their teams as they seek to drive innovation and improve employee engagement. Rex believes that curiosity and understanding are essential for effective collaboration and he shares practical tips for leaders hoping to move their organizations forward in our new world of work. Embracing a move from "think tank" to "do tank" is the call to action as Mike and Rex offer the insights and inspiration you need to be a Workplace Innovator! Connect with Rex on LinkedIn: https://www.linkedin.com/in/rexmiller/ Learn more about Genius Spark: https://rexmiller.com/genius-spark Discover free resources and explore past interviews at: https://eptura.com/discover-more/podcasts/workplace-innovator/ Learn more about Eptura™: https://eptura.com/ Connect with Mike on LinkedIn: https://www.linkedin.com/in/mikepetrusky/  

Chad and Jordan react to the NFC championship, teambuilding, and dynasty trades of depressed value players.Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

Creepypasta Scary Story https://brett-schumacher-shop.fourthwall.com

Esperanza and Irwin delve deep into one of the most unknown of East End stories. The Lindisfarne Association (1972 -2012) was a nonprofit foundation and diverse group of intellectuals organized by cultural historian William Irwin Thompson for the "study and realization of a new planetary culture". With a cast of characters from the worlds of art, science, religion, poetry and medicine (including Dr. Jonas Salk), the collective brainpower was through the proverbial roof. And all of it on a campground at Fish Cove in North Sea, Southampton. Listening is Believing.

Ops Sindoor was a conflict that saw use of long range vectors, both air to air and air to ground along with massive use of drones, loitering munitions and air defence in play. ThePrint's Editor - Defence and Diplomacy Snehesh Alex Philip tells us more about a report on Ops Sindoor by Swiss military think tank Centre for Military History and Perspective Studies in #DefenceScope

Chad and Jordan discuss Zach Charbonnett's injury fallout and C.J. Stroud's market.Plus trades!Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

In this episode of Pekingology, CSIS Senior Fellow Henrietta Levin is joined by Sabine Mokry, Postdoctoral Researcher with the Institute for Peace Research and Security Policy at the University of Hamburg and author of the new book Chinese Scholars and Think Tanks' Construction of China's National Interest. Sabine unpacks the process through which outside expertise can shape the Party's national security concepts, the relevance of Chinese think tanks and scholars in policymaking, and how China – nearly a thousand miles from the Arctic – became a “near-Arctic State.”

The DGS Think Tank with Michael Butler & Steve Ehlmann- h4 full 1009 Tue, 20 Jan 2026 22:37:14 +0000 nlMs1lyCf2XfM6TA4eLgMILc2MMdWk47 comedy,religion & spirituality,society & culture,news,government The Dave Glover Show comedy,religion & spirituality,society & culture,news,government The DGS Think Tank with Michael Butler & Steve Ehlmann- h4 The Dave Glover Show has been driving St. Louis home for over 20 years. Unafraid to discuss virtually any topic, you'll hear Dave and crew's unique perspective on current events, news and politics, and anything and everything in between. © 2025 Audacy, Inc. Comedy Religion & Spirituality Society & Culture News Government False https://player.amperwavepodcasting

Chad and Jordan discuss the fallout from the first weekend of the NFL playoffs, George Kittle's injury, and risers/fallers from week one.  Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

In episode 1990, Jack and Miles are joined by comedian, writer, journalist, and host of The Bitchuation Room, Francesca Fiorentini, to discuss... Markwayne Mullin Not Sure What A Regime Is Or What Change Is, RFK Jr With A BANGER Appearance On Katie Goebbels’ Podcast Between Two Swastikas, Dems Willing To Stay Out Of Power To Appease Donors and more! Markwayne Mullin Not Sure What A Regime Is Or What Change Is RFK Jr With A BANGER Appearance On Katie Goebbels’ Podcast: Between Two Swastikas Katie Miller to RFK JR.: "What brand of vitamins do you take?" Gavin Newsom comes out swinging against California billionaire tax Searchlight Memo to Interested Parties: Reform and Retrain ICE, Don’t Abolish It LISTEN: Knock Yourself Out (feat. Pharrell) by JadakissSee omnystudio.com/listener for privacy information.

What happens when war becomes a market and foreign policy turns into an odds board? We dive into the uneasy world of prediction platforms like Polymarket and Kalshi, where traders place bets on battlefield maps, covert raids, and even the exact words politicians will say. With researcher Nick Cleveland Stout from the Quincy Institute, we unpack how a briefly altered Ukraine map preceded a major payout, why a $400,000 win hit just hours before a surprise operation in Venezuela, and how these signals can tip off adversaries long before headlines catch up. Together we explore the ethics and incentives behind “the news of tomorrow today.” If market rules hinge on a single source, a map tweak or an official statement can decide millions—inviting manipulation rather than insight. We look closely at the regulatory blind spot: the CFTC treats these venues as prediction markets, leaving no insider trading framework even when life-and-death events are on the line. That vacuum tempts those with privileged access to profit, while retail bettors absorb the risk and confusion. The conversation follows the money. Defense contractors tout hardware after high-profile raids, budgets swell, and the arms industry wins. Oil players eye Venezuela's reserves and refineries, with some majors ready to expand and others demanding ironclad guarantees after prior expropriations. We examine how talk of reimbursements, control over refining, and contested asset sales like Sitgo feed a broader strategy to exert power without boots on the ground—and how markets amplify or distort that story. If prediction markets can surface real signals, they can also nudge reality. We outline concrete guardrails: diversified resolution sources, audit trails, institutional no-trade policies, event-type limits for active conflicts, and anomaly flags when flows cluster around sensitive moments. Then we ask the core question: should anyone profit from outcomes they can influence? Listen and decide with us, and if this conversation sharpened your thinking, follow the show, share it with a friend, and leave a review so others can find it.

The DGS Think Tank with Daniela Velasquez & Kurt Bahr- h4 full 1104 Tue, 13 Jan 2026 22:35:33 +0000 vylsxBb7kV0SBTVpWwuuc67iypIqdbOf comedy,religion & spirituality,society & culture,news,government The Dave Glover Show comedy,religion & spirituality,society & culture,news,government The DGS Think Tank with Daniela Velasquez & Kurt Bahr- h4 The Dave Glover Show has been driving St. Louis home for over 20 years. Unafraid to discuss virtually any topic, you'll hear Dave and crew's unique perspective on current events, news and politics, and anything and everything in between. © 2025 Audacy, Inc. Comedy Religion & Spirituality Society & Culture News Government False https://player.amperwavepodcasting.

Cody Alexander of MatchQuarters joins the Nation to have an "Defensive Think Tank" conversation full 954 Mon, 12 Jan 2026 23:13:18 +0000 9Ik5A3YU4gGTIxFkJCSlouWz0zpvSRi2 nfl,dallas cowboys,sports GBag Nation nfl,dallas cowboys,sports Cody Alexander of MatchQuarters joins the Nation to have an "Defensive Think Tank" conversation The G-Bag Nation - Weekdays 10am-3pm 2024 © 2021 Audacy, Inc. Sports False

Chad and Jordan discuss the early offseason, trades, and how to implement a winning strategy.Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

The DGS Think Tank with Dennis Hancock & Donna Baringer- h4 full 1139 Tue, 06 Jan 2026 22:32:02 +0000 R7UsGCrN3OslYHbllEgjkHYn5mlgm3WR comedy,religion & spirituality,society & culture,news,government The Dave Glover Show comedy,religion & spirituality,society & culture,news,government The DGS Think Tank with Dennis Hancock & Donna Baringer- h4 The Dave Glover Show has been driving St. Louis home for over 20 years. Unafraid to discuss virtually any topic, you'll hear Dave and crew's unique perspective on current events, news and politics, and anything and everything in between. © 2025 Audacy, Inc. Comedy Religion & Spirituality Society & Culture News Government False https://player.amperwavepodcastin

Chad and Jordan discuss the final week of the season and look to the future with some rules to consider when trading in the offseason.Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

Welcome to Season 11 of the Rethink Community Podcast: The Best Of! For the past five years, the Rethink Community Podcast has been a space to challenge how we understand and respond to poverty. We've shared stories that move beyond theory and spark those "aha moments" that can change perspectives, relationships, and actions. In this special season, we're bringing you the best of our past episodes—powerful stories, inspiring conversations, and thought-provoking insights that have resonated most with our listeners. You'll hear from individuals with lived experience in poverty, addiction, or incarceration; people who have built bridges across race and class; and leaders whose understanding of poverty has shifted through real-world experience. Whether you're new to the podcast or a longtime listener, these episodes capture the heart of what Rethink Community is all about: opening our eyes, expanding our empathy, and sparking new ideas for a more just and connected world. So, get ready to revisit some of our most compelling conversations and join us in Season 11—the best of Rethink Community. Original Air Date: Season 7, Spring 2023 In 2010, a group of people from Greater Dayton Ohio, teamed up with Think Tank, Inc. to share their personal experiences with poverty. Their stories became the foundation for the Cost of Poverty Experience — a simulation that gives people a glimpse into the lived realities of poverty. Since then, COPE has helped thousands across the country see poverty from a human perspective. Now, some of those original storytellers are back to share where life has taken them, the relationships and resources that shaped their journeys, and their powerful reflections on how we talk about poverty in America today.  This compilation includes clips from the following guests: Carlos Guajardo Krisitin Hicks Melissa Massey Ken Moss  

In this episode, Dan Hugger speaks with Kris Mauren, co-founder and president of the Acton Institute, about all things Acton. What was the original, animating idea behind the founding of the Acton Institute? Why a think tank? What makes Grand Rapids so grand? What are the greatest challenges Acton faces in fulfilling its mission? What […]

Chad and Jordan react to a tough week 16 plus dynasty trades heading into week 17 championships!Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

Ce lundi 22 décembre, l'échec de la CMP et le retour de la loi spéciale ont été abordés par Christian Saint-Étienne, économiste, Ludovic Desautez, directeur délégué de la rédaction de La Tribune, et Victor Lequillerier, économiste et vice-président du Think Tank "BSI Economics", dans l'émission Les Experts, présentée par Raphaël Legendre sur BFM Business. Retrouvez l'émission du lundi au vendredi et réécoutez la en podcast.

Ce lundi 22 décembre, Christian Saint-Étienne, économiste, Ludovic Desautez, directeur délégué de la rédaction de La Tribune, et Victor Lequillerier, économiste et vice-président du Think Tank "BSI Economics", ont fait une rétrospective de l'année 2025 dans l'émission Les Experts, présentée par Raphaël Legendre sur BFM Business. Retrouvez l'émission du lundi au vendredi et réécoutez la en podcast.

Ce lundi 22 décembre, Raphaël Legendre a reçu Christian Saint-Étienne, économiste, Ludovic Desautez, directeur délégué de la rédaction de La Tribune, et Victor Lequillerier, économiste et vice-président du Think Tank "BSI Economics", dans l'émission Les Experts sur BFM Business. Retrouvez l'émission du lundi au vendredi et réécoutez la en podcast.

Chad and Jordan discuss how to handle the Patrick Mahomes ACL tear and how to not make a bad situation way worse.Plus lots of trades and strategy.  

The DGS Think Tank with Ian Mackey & Steve Ehlmann- h4 full 931 Tue, 16 Dec 2025 22:36:21 +0000 fLLWzYpSI6lL7XcJ2zIISroezwAIbMNH comedy,religion & spirituality,society & culture,news,government The Dave Glover Show comedy,religion & spirituality,society & culture,news,government The DGS Think Tank with Ian Mackey & Steve Ehlmann- h4 The Dave Glover Show has been driving St. Louis home for over 20 years. Unafraid to discuss virtually any topic, you'll hear Dave and crew's unique perspective on current events, news and politics, and anything and everything in between. © 2025 Audacy, Inc. Comedy Religion & Spirituality Society & Culture News Government False https://player.amperwavepodcasting.com

Schön, dass du reinschaltest! Ich habe grad befristet eine Geschenkmitgliedschaft von meinem wöchentlichen Newsletter im Angebot. Der Mensch erfährt, dass er von dir beschenkt wurde, aber nicht, was du bezahlt hast. Das Abo endet automatisch nach einem Jahr. Ich freue ich mich über deinen Support! Meinen Podcast schon abonniert? Wenn dir diese oder auch eine andere Folge gefällt, lass´ gern eine Bewertung da und/oder supporte mich per Ko-Fi oder PayPal. Anfragen an backoffice@katja-diehl.de! Zusammen mit Carlo Severini aus der Schweiz habe ich mir eine dreitägige Exkursion der guten Dinge in der Mobilität überlegt. "Learn & Travel" nenne ich das Format und es soll euch zeigen, dass alles möglich ist, wenn wir nur wollen. Schaut mal vorbei, ob das nicht auch für euch oder eine Person, die ihr kennt, eine gute Idee sein könnte! Vera Huwe hat eine wissenschaftliche Arbeit geschrieben zu, im weiteren Sinne, Fragen von sozialem Klimaschutz im Verkehr und durfte damals zu meinem Buch "Autokorrektur" beitragen. Jetzt arbeitet sie seit ungefähr einem Jahr für das Dezernat Zukunft, einen Think Tank in Berlin. Und wir beschäftigen uns vor allem mit öffentlichem Geld und öffentlicher Finanzierung. Niklas Höhne ist seit Anfang des Jahres beim Dezernat Zukunft und beschäftigt sich vor allem mit der Schnittstelle von Klimapolitik und Fiskalpolitik, also allem, was mit der Finanzierung von Klimapolitik zu tun hat. Wir starten mit einem Reality-Check zum Bundeshaushalt. Immer wieder höre ich in Talkshows von Unions-Politikern, dass Deutschland ja so viel Geld für die Schiene ausgibt wie noch nie. Niklas erklärt, was dahinter steckt: "Die gute Nachricht und das große positive Signal ist, dass es tatsächlich einen Mittelaufwuchs gibt. Das gilt für alle Verkehrsträger: für Wasserstraßen, für Straße, für Schiene und auch einen größeren Fokus auf den Bestand. Das ist erst mal gut, das finden wir super. Die Finanzierung wird so ein bisschen komplizierter. Wir haben seit Anfang des Jahres ein großes Sondervermögen dazu bekommen: 500 Milliarden über die nächsten 12 Jahre für Infrastruktur. Es wird aber nicht nur daraus finanziert, sondern auch aus dem Verkehrsetat und auch aus dem Verteidigungsetat." Vera ergänzt kritisch: "Es ist tatsächlich so, dass wenn man sich die Zahlen anschaut, die jetzt so im Raum stehen – ich glaube, es sind über 80 Milliarden für die Schiene in den nächsten Jahren – dann klingt das erst mal nach sehr viel. Aber wenn man dann wirklich reinguckt und fragt: Okay, was davon ist wirklich zusätzlich? Was davon kommt aus dem Sondervermögen? Was kommt aus dem regulären Etat? Dann wird es schnell komplizierter. Und vor allem: Was davon geht wirklich in den Schienenausbau und in die Sanierung? Und was davon geht zum Beispiel an die Deutsche Bahn als Unternehmen für andere Zwecke?" Ein zentrales Thema sind die Trassenpreise – ein Begriff, mit dem viele zunächst nichts anfangen können. Niklas erklärt: "Trassenpreise, das sind die Preise, die Eisenbahnverkehrsunternehmen – also die, die die Züge fahren – an den Infrastrukturbetreiber zahlen müssen, um die Schienen nutzen zu dürfen. Das ist so ähnlich wie eine Maut auf der Straße, nur eben für die Schiene." Vera bringt das Problem auf den Punkt: "Hohe Trassenpreise machen den Bahnverkehr teurer. Das trifft vor allem den Güterverkehr und den Fernverkehr. Und das macht die Bahn im Wettbewerb mit anderen Verkehrsträgern weniger attraktiv."

Enrique Dussel Peters has a Ph.D. in Economics at the University of Notre Dame. Professor at the Graduate School of Economics, Universidad Nacional Autónoma de México since 1993. He is Coordinator of the Center for Chinese-Mexican Studies of the School of Economics at UNAM and of the Academic Network of Latin America and the Caribbean on China. His most recent book is “Latin America, China & Great Power Competition.”  The US appears to be abandoning the Bretton Woods structure and some UN programs. US leadership with President Donald Trump is no longer dependable. Withdrawal from international institutions is foolhardy and counterproductive. Many experts are touting China as the emerging world leader. China is using Soft Power, such as the Belt and Road Project, to accomplish foreign policy goals. Eliminating USAID by President Trump damaged the reputation, alliances, efficiency and effectiveness of the US in many areas of the world. 

It's time to map out the Mets' offseason on the latest episode of the Just End The Suffering podcast! Host Mike Phillips (⁠⁠⁠⁠@MPhillips331⁠⁠⁠⁠) kicks off the show by recapping the big moves of the Winter Meetings (1:26), which were headlined by the departures of Edwin Diaz and Pete Alonso from the Mets. Mike is then joined by Martino Puccio (@MartinoPooch) for a deeper dive into what's next for the Mets (11:27) this offseason and to make their Week 15 NFL Picks (57:17). Mike then shares his initial thoughts on the CFP selection controversy (1:14:27) in the Two Minute Drill.Subscribe to the Just End The Suffering podcast on ⁠⁠⁠⁠⁠⁠⁠Apple⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠Amazon⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠TuneIn⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠ and⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠Spotify⁠⁠⁠⁠⁠⁠⁠!Subscribe to ⁠⁠⁠⁠⁠⁠⁠Mike Phillips's channel⁠⁠⁠⁠⁠⁠⁠ on YouTube!

Chad and Jordan discuss the Colts falling off the rails, plus the fantasy playoffs.  Plus trades, including check ins on Achane, Judkins, and Gadsden. Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

The DGS Think Tank with Michael Butler & Kurt Bahr- h4 full 1017 Tue, 09 Dec 2025 22:32:31 +0000 kkw98RqxHOl9LyjDtiaeQ2qsOcrRwTdJ comedy,religion & spirituality,society & culture,news,government The Dave Glover Show comedy,religion & spirituality,society & culture,news,government The DGS Think Tank with Michael Butler & Kurt Bahr- h4 The Dave Glover Show has been driving St. Louis home for over 20 years. Unafraid to discuss virtually any topic, you'll hear Dave and crew's unique perspective on current events, news and politics, and anything and everything in between. © 2025 Audacy, Inc. Comedy Religion & Spirituality Society & Culture News Government False https://player.amperwavepodcasting.com

Episodio 881 de Contralínea En Vivo conducido por Nancy Flores y Aníbal García: -Consejo Mexicano de Negocios, detrás de ONG y ‘think tanks' opositores a 4T- Transmisión 07 de julio de 2025 CONTRALÍNEA EN VIVO se transmite de lunes a viernes a partir de las 10:00hrs (hora del centro de México) a través de Facebook live, YouTube y Telegram. La MESA DE ECONOMÍA POLÍTICA se trasmite todos los lunes a partir de las 14:00hrs. Nuestro programa de análisis, AMÉRICA INSUMISA, se trasmite los martes a partir de las 14hrs. AGENDA DE SEGURIDAD NACIONAL es los miércoles a partir de las 14:00hrs Estamos en Facebook, YouTube, Twitter, TikTok, Instagram, Whatsapp y Telegram como Contralínea. Escúchanos en Spotify, Apple Podcast e Ivoox como Contralínea Audio.

Chad and Jordan discuss strategies about how to optimize your lineup in the playoffs.  Remember: Think Elite!Plus trades, including check ins on Kyler Murray and Justin Jefferson.  Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

It's time to map out the Yankees' offseason on the latest episode of the Just End The Suffering podcast! Host Mike Phillips (⁠⁠⁠@MPhillips331⁠⁠⁠) kicks off the show by sharing his thoughts on what the Yankees could be up to in the offseason (1:47) as they try to make up ground on the Toronto Blue Jays in the American League East. Mike is then joined by the podcast's legal correspondent, Phil Fraietta, to dive deeper into what the Yankees may try to do over the winter (7:01) to address their needs. Mike then makes his Week 14 NFL Picks (49:27) with Will Smith of the Sorry To Interrupt podcast and reviews Volume 1 of Stranger Things Season 5 (1:08:08) with pop culture correspondent Sam Derosa (@SDeros5) to wrap up the show.Subscribe to the Just End The Suffering podcast on ⁠⁠⁠⁠⁠⁠Apple⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠Amazon⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠TuneIn⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠ and⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠Spotify⁠⁠⁠⁠⁠⁠!Subscribe to ⁠⁠⁠⁠⁠⁠Mike Phillips's channel⁠⁠⁠⁠⁠⁠ on YouTube!

The DGS Think Tank with David Barklage & Jeff Rainford!- h4 full 1014 Tue, 02 Dec 2025 22:35:52 +0000 aTJckjdj3afay9MfZg8VxXBrFhcWhZDa comedy,religion & spirituality,society & culture,news,government The Dave Glover Show comedy,religion & spirituality,society & culture,news,government The DGS Think Tank with David Barklage & Jeff Rainford!- h4 The Dave Glover Show has been driving St. Louis home for over 20 years. Unafraid to discuss virtually any topic, you'll hear Dave and crew's unique perspective on current events, news and politics, and anything and everything in between. © 2025 Audacy, Inc. Comedy Religion & Spirituality Society & Culture News Government False https://player.amperwavepodcastin

In today's episode we conclude our read-through of Ch. 6 from my book The Coming World Nation, which is titled “Technocracy: Government in the Scientific Age.” The final two sections from the chapter we'll be covering are called “Technocracy's Hub-and-Spoke Model” and “The International Rules-Based Order.” The former discusses the idea that technocracy must be centered around a think tank governance structure, while the latter discusses how the IRBO has long served as a primary focal point of the technocratic revolution. Also, I'm launching a fundraiser/sale at my online store. Hats, Shirts, and Books are all on sale, plus a new shirt featuring psychologists Carl Jung and Stanislav Grof. Please consider buying something to support my work!Table of Contents00:00 – Introduction07:00 – Announcements & Store Sale08:47 – The Hub and Spoke Model of Technocracy30:14 – The International Rules-Based Order40:47 – Conclusion & What's Next

Chad and Jordan discuss strategies late in the season to add to your team and avoid big mistakes.Plus trades involving Ashton Jeanty, Tyler Warren, Jaxson Dart, J.J. McCarthy, and Michael Penix.Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

The DGS Think Tank with Steve Butz & Judge Tom Frawley- h4 full 956 Tue, 25 Nov 2025 22:31:44 +0000 vfvpwrTWM961GGuflG3DxkmB82IjW13p comedy,religion & spirituality,society & culture,news,government The Dave Glover Show comedy,religion & spirituality,society & culture,news,government The DGS Think Tank with Steve Butz & Judge Tom Frawley- h4 The Dave Glover Show has been driving St. Louis home for over 20 years. Unafraid to discuss virtually any topic, you'll hear Dave and crew's unique perspective on current events, news and politics, and anything and everything in between. © 2025 Audacy, Inc. Comedy Religion & Spirituality Society & Culture News Government False https://player.amperwavepodcasting

Chad and Jordan discuss the trade tactics ahead of dynasty trade deadlines.Plus, trades!Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

Geoff Clark links up with David Troy to cut through the Week 12 board with clear-eyed analysis and zero fluff. They cover the entire slate, from early Sunday kickoffs to Monday night, spotlighting matchup edges, injury ripple effects, and market moves that actually matter. **The time codes might be off because of ad insertions**

The DGS Think Tank with Steve Ehlmann & Donna Baringer- h4 full 1030 Tue, 18 Nov 2025 22:31:56 +0000 IN2N2T5CZhPpP5FzvlAhcbqZ9ou0J4eC comedy,religion & spirituality,society & culture,news,government The Dave Glover Show comedy,religion & spirituality,society & culture,news,government The DGS Think Tank with Steve Ehlmann & Donna Baringer- h4 The Dave Glover Show has been driving St. Louis home for over 20 years. Unafraid to discuss virtually any topic, you'll hear Dave and crew's unique perspective on current events, news and politics, and anything and everything in between. © 2025 Audacy, Inc. Comedy Religion & Spirituality Society & Culture News Government False https://player.amperwavepodcasting

In Episode 132: Hollow Earth and What Lives Within, we “dive in” to hollow Earth with another edition of the Think Tank! Is a hollow Earth really possible? If so, why is it there? Who lives inside of it? What is it being used for? These thought-provoking questions and many more will be covered as Justen Faull, Wes Faull, Chad Riley, and Jim Wilhelmsen join The Confessionals to discuss the mysterious hollow Earth. Please pray for Tony's wife, Lindsay, as she battles breast cancer. Your prayers make a difference! If you're able, consider helping the Merkel family with medical expenses by donating to Lindsay's GoFundMe: https://gofund.me/b8f76890 Become a member for ad-free listening, extra shows, and exclusive access to our social media app: theconfessionalspodcast.com/join The Confessionals Social Network App: Apple Store: https://apple.co/3UxhPrh Google Play: https://bit.ly/43mk8kZ Tony's Recommended Reads: slingshotlibrary.com If you want to learn about Jesus and what it means to be saved: Click Here Bigfoot: The Journey To Belief: Stream Here The Meadow Project: Stream Here Merkel Media Apparel: merkmerch.com My New YouTube Channel Merkel IRL: @merkelIRL My First Sermon: Unseen Battles SPONSORS SIMPLISAFE TODAY: simplisafe.com/confessionals GHOSTBED: GhostBed.com/tony CONNECT WITH US Website: www.theconfessionalspodcast.com Email: contact@theconfessionalspodcast.com MAILING ADDRESS: Merkel Media 257 N. Calderwood St., #301 Alcoa, TN 37701 SOCIAL MEDIA Subscribe to our YouTube: https://bit.ly/2TlREaI Reddit: https://www.reddit.com/r/theconfessionals/ Discord: https://discord.gg/KDn4D2uw7h Show Instagram: theconfessionalspodcast Tony's Instagram: tonymerkelofficial Facebook: www.facebook.com/TheConfessionalsPodcas Twitter: @TConfessionals Tony's Twitter: @tony_merkel Produced by: @jack_theproducer

KATIE MATHEWSONKatie Mathewson is an Emmy-nominated and Peabody Award-winning screenwriter/producer who has been working with her writing partner, Tanner Bean, for over a decade. The duo got their start on Fox's PITCH, but since then, their credits have included Marvel Studios' HAWKEYE, Amazon's JURY DUTY, and Showtime's DEXTER prequel. Katie and Tanner are currently Co-Executive Producers on Season 2 of DEXTER: RESURRECTION. Katie's passion for LGBTQ+ activism and DEIA has led her to work with the Think Tank for Inclusion & Equity (TTIE). She previously served as Co-Chair of the LGBTQ+ Writers Committee, during which time she co-founded the Rainbow Pages – an independent database of queer WGA writers – and helped secure better healthcare coverage for transgender Guild members.THINK TANK INCLUSION & EQUITY (TTIE) & HOROWITZ RESEARCH RELEASE BEHIND THE SCENES: THE STATE OF INCLUSION & EQUITY IN TV WRITING 2025 REPORTY. SHIREEN RAZACKShireen is a South Asian, Trinidadian, Canadian, Muslim-American drama writerwith an affinity for science fiction, fantasy, and supernatural stories steeped in social justice allegory. Born in Canada, mostly raised in Texas, and a graduate of The University of Texas at Austin, Shireen started her professional life with a career in advertising that took her from Texas to New York, then ultimately to Los Angeles, where she came to pursue her dream of writing for television. She is an alum of the CBS Writers Mentoring Program and now has over fifteen years of TV writing experience in multiple genres, including sci-fi/fantasy/supernatural, YA, and both medical and cop procedurals. Most recently, she was a Co-Executive Producer on Vampire Academy for Peacock.Shireen is also a co-founder and co-chair of Think Tank for Inclusion & Equity (TTIE), a member of the Board of Directors for the Writers Guild Foundation, a Writers Guild of America West mentor, and a black belt in San Soo Kung Fu.

Chad and Jordan discuss the big weeks of Tyler Shough, TreVeyon Henderson, and JT's special season.Plus, trades!Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

Revamping your financials is as easy as … Kiera shows off her savvy financial skills by sharing what it takes to know what's being spent in your practice. Her spreadsheet tips will answer such questions as: What can be cut? How can you make sure your overhead is in check? What do you need to produce? And much more. Want a sample spreadsheet to get started? Email hello@thedentalateam.com.  Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: Kiera Dent (00:00) Hello, Dental A Team listeners, this is Kiera and I hope you're just having an amazing day. Like a great, great, great, incredible day. ⁓ just, today's topic is one that makes me excited and it's so dry and boring, ⁓ but I love it. And I'm like, that's probably a buzzkill for the podcast, but you know me, one of my core values is fun. And Dana, shout out to Dana, DanyDane over there.   ⁓ She gave me one of the best compliments. We do a thing on Wednesdays called core value shout out in our company. And I will tell you if you do not have this in your company, I would strongly advise you do this. What we do is every single Wednesday, our company goes and our whole team says that this is our favorite. You guys, we have gone from a very small team to a much larger team and we still do this. So just know small teams, big teams, it is doable and it is very   relevant and very essential. And I think it just goes so well. I am okay to take a little bit longer on this morning huddle because of how good it is. so core value shout out is where we just randomly will pick somebody and then it's popcorn after that. So they'll choose the next person. So for example, we would start and I would say, okay, Shelbi starting today and everybody chooses somebody on the team and they highlight them for a core value and it has to be a core value. It has to be something specific. And so Dana gave me one of the greatest compliments.   She said, Kiera, she said she wanted to give me the core value of fun, because fun is really one of our core values. And she said, I want to give it to you for fun, because she said a lot of times topics that are so hard ⁓ or things that people wouldn't necessarily find fun. She said, you just know how to sprinkle the fun and the confetti and the glitter and make things that are hard or something that teens wouldn't want to do or doctors wouldn't want to do.   you make them really fun. And honestly, that has stuck with me. It is a few days later since she gave me that compliment and I'm still remembering it. So not only is core value shout out day amazing, it also helps you just enjoy and to have like, to be happier. ⁓ It also infuses core values into your company. And I'm excited and grateful that I'm able to bring fun things to the podcast, a dry topic. I hope I've teed this up enough to where you're excited about it.   But this is, think, the discipline side of business of owning a dental practice that you need to do. And this is really, think, for office managers or billers and doctors. And this is something that I think will give you so much confidence. it came actually from our doctor mastermind. We have ⁓ a private doctor only mastermind that we run every single month. It's a virtual one. And then we do an in-person one ⁓ that's more for doctor and leadership teams. But our monthly one, call it Think Tank, and it's on the first Tuesday of every month. And a doctor was saying, she's like,   I just don't know where to cut. I said, send me your PNL and tips like, and she's going to want your credit card statement and she's going to want all your stuff. And while yes, I am obsessive on this. have helped family members. I've helped offices. I've helped myself. something that I will like toot my own horn on it. I actually think I'm very talented with money, with saving, with figuring out solutions and helping people understand where you can cut. This podcast also came about because this morning on my, ⁓ Shelbi Britt and I were meeting and we were literally going through.   our finances to see where could we maybe squeeze the tube of toothpaste a little bit more, where could we maybe change a few things. And I think that that's just so relevant and so helpful. And so this is something I do in my day in day out life. It's something that I think for you to go from chaos and lack of financial clarity to confidence is something that I really want to just bring to the table today on the podcast. If you're new to Dental A team, welcome. We are obsessed about helping you have your best life and ⁓ doing it in a fun, easy way through dentistry. And so   helping you with our yes model. So you as a person getting your life, your vision, all of that in place, then moving into earnings. So ⁓ financially, that's the piece today. And then using those financial pieces. So your analytics, your PNL, your overhead to also help us figure out what systems and team development need to go into place to make sure you have this thriving practice. Because honestly, I believe that being successful, being a successful dental practice does not have to be hard and it can actually be easy. So that's what we're here for today. ⁓ With that.   So today it's going to be like, how do you actually like figure out your costs? So I did this a long time ago and then I like met a lot of really smart financial people. I'm not a financial advisor. I will throw that out there. So just make sure you talk to them and you have your, ⁓ like you chat with them of what's best for your state, but I will teach you how I do it. This is annoying. It's a little cumbersome, but people love to hear like, how do you actually do this? I'm always like, how do people get like jacked? Like how do they work out? Like.   me like what time do you work out like what do you do for your nutrition and just so I understand the full landscape and then I'm going to pick and choose of what's going to work well for me that I'll actually implement so hopefully that will be effective for you today as well.   So this is what we do. I have a spreadsheet that I have for monthly costs. We do this with all of our clients too. So if you're like, this feels too hard, don't worry, join the Dental A Team. We'll help you get it put together. So we have a monthly cost. And what I do is on the monthly costs, and this is probably my most visited spreadsheet of my entire company. And I'm super excited because we're bringing in another team member who does financial.   Forecasting and has a whole background in finance. So my method might get revamped to 2.0 and there's always another layer. But what I have is I have on our monthly costs, I have all the salaries and all of the pay. Now for offices, I do include doctor pay. Again, I'm not a CPA and I do believe that doctors should be paid. So I put in either your W-2 salary and or your doctor compensation of 30%. Now I do lose numbers. So our consultants are paid very similar to how doctors are paid.   ⁓ And so you can get a general idea. So mine are general ideas. It's not my highest month. It's not my lowest month. It's the average is what I've selected to do for these costs. So again, this spreadsheet will not be absolutely perfect, but I think it's a really great tool to figure out what can I cut? How can I make sure my overheads in check? What do I need to produce? How do I basically figure out my BAM, my bare ACE minimum in a company? And so that's what we're gonna be looking at. So with that, I first list all the salaries and...   I want everything in there. And then what I have is a current. So I'm gonna have a current and then I'm also going to have like a future. So for example, if you're planning to hire somebody, but they're not hired yet, that's something that you're going to wanna know, what is my cost now? And what is going to be the future cost? Because those two things are actually different numbers. And so for me, it's really helpful so that I can look at you guys honestly.   When I started this, had like three team members and now we have tons of team members on there and outsource people and virtual assistants. And ⁓ the list just gets bigger and bigger and bigger. I can go back and I can look at things that we've done before. And so mine's on Google Sheets. And again, we've built one of these and I'm even happy to share, reach out, Hello@TheDentalATeam.com. But this is something, so I go through all the salaries. And then for me, ⁓ if you do health insurance or you do a health stipend or whatever it is, you add that in.   as well, but then what I do, and again, talk to your CPA, see what your payroll tax are. For me, I just estimate 10%. I always like to air higher. So you will notice in all of my projections and everything I do, I'm going to always air higher than it actually is rather than lower. And so just looking at that, just so you know, that's how I do. So my CPA told me 10%, we have business in four different states. I think we're actually up to five now.   So I estimate high, no matter what state they're in, I just do a 10%. So I'll do my total salaries of the month, an estimated 10 % payroll. And then I've got that in there, my total payroll. Then we have our health stipends or health insurance, our 401k costs in there, how much it costs me per user, what the 4 % is. I actually go grab people's salaries and their bonuses, put it in there. So I have a pretty good idea. Then what I do is I check every single month to see based what I have here, is that close?   to what I'm actually paying or is it not? I know some of you might be like, well, here, I just get it from my CPA, I get a P &L. I agree, but this is a good checks and balance between my CPA and myself. And also when I'm trying to project and forecast, can I add people in? How much is this gonna have? Where can I cut? If I can see it all line itemed out, it's actually for me at least much easier for me to see what are all my costs and where can I squeeze the tube of toothpaste to get a little bit more ⁓ toothpaste out of that tube or a little more juice out of the lemon.   So that's what I have. And then what I have down below is like outsource. So if you've got VAs or you've got ⁓ different people that are contractors or things like that, I have that in there and that one EBS and flows mostly that hangs in my marketing department. That's where I have a lot of those. And then also VAs and EAs that'll be in there that are virtual assistants that are through other companies. So they're not running on my payroll, but they are down there. Like I have some consultants on there. I've got some coaches on there that will be in that section for me. But those again are not up in that payroll section because I'm not paying that.   payroll tax on them and I'm also not 401k on them, but that helps me see how much am I paying in outsourced resources to see should I cut that, should I keep that, how much do I have on the top, is my payroll heavy. You also can break this down by department. So you can see how much am I paying in my hygiene department, are they offsetting, how much am I paying my doctor department, my front office department, all those different departments. If you want to get even more granular, you can. And then below that, I have all of the office expenses and this is something really great.   This year Britt she ⁓ 2.0'd us and she put in their end of year expenses because there's a lot of things that I just pay at the end of the year that are annual subscriptions that will save money on but the reality is I should probably be saving that money throughout the year, right? Because every single month there would be an expense allocated if I didn't pay it annually. So we should be adding that in so we're saving for that. We're preparing for that for the end of the year. We have different things in there. So like all of our subscriptions that we have you might have Netflix, you might have Audible, you might have   Canva for marketing, ⁓ ChatGPT if you're paying for those subscriptions, anything. And I'm constantly updating this like as you hear ChatGPT and how many do we have for that? ⁓ We use our project management software is on there. I also know that every single month I have a budget allotted for employee gifts and anniversaries. And so we have an allotment of how much we spend. I do double check this, but I try to break it down. Also I have in there my merchant fees and how much my merchant fees are on average.   ⁓ And I literally list everything out. So whether it's personal, because like Audible and my phone, I do have those on there. Those are personal things for me that do run through the business, but there's still business expenses that will need to be on there. ⁓ And then we've got our bookkeeping and our accounting or CPA, our lawyers, all of that in there. If you have vehicles that your CPA said is okay for you to run through, all of that, your rent, your mortgage, your supplies, your internet, all of that in there.   to where at the bottom of this list, you can get a complete grand total for the month. And what's really awesome about that, you can actually break it apart so you can have doctors where they're not in there. This then tells you basically your BAM, your bear ace minimum. And then what we can do from there is we can figure out what you need to produce to be able to hit. So hopefully all that was like not too much. just rattle, I'm like literally looking at my spreadsheet as I'm telling you this, all of that. Then below that, we're gonna wanna also add in debt services because debt services are also going to hit your cashflow side of it.   So when you have these two tools together, then you can figure out what's bam, my bare ace minimum, what's my overhead and then what can I cut and then what do I need to produce? Then we can figure out what we need to produce with block schedules. There's like a whole other zone, but back to the client's question. She said, I don't even know what to cut. So today me and our leadership team, we were going through this and we literally looked to see, okay, what's on our office expenses? And I know this sounds so dumb and so like trite.   but I think it's the discipline of knowing how to do this because you better believe when I'm looking at my monthly expenses, which are outlandish and they're very high. When I look at this, saving 40 bucks a month is not like, it's truly a literal spit in the bucket. But when I think about it, it's $40 here, it's $20 there. It's just like your credit card statement at the end of the month. I'm always shocked at how much is on there and it's $20 on Amazon here, $30 over here.   $20 there and all those $20, $30 purchases add up to multiple thousands of dollars every single month. So when we look at this, I look at every single office expense and I'm like, okay, is Adobe something that we need? And this was actually a catch that we had. I was like, we're paying $65 a month for Adobe. Do we still need the entire suite? The answer is no, we don't. We only need it for a small thing. And then we started thinking like, softwares are evolving. So we're like, does G Suite ⁓ actually cover that? Or...   does another one of our subscriptions cover it? Because so many times our subscriptions that we're paying are like duplicates of something else. G Suite has expanded and I'm like, do we still need to use boomerang? I use boomerang all the time. I love boomerang so much, but I'm like, has G Suite evolved to where they have something comparable to it that we could cut the boomerang is 120 bucks a month for us. And Shelbi was like, wait, not all of our team members, like our marketing team does not use boomerang. They're not doing client facing emails. They rarely are in their inbox. They're in Slack all the time.   she's like, what if we reduce the number of people on boomerang that would actually cut our costs down. So again, it's this like fine tuning revolving through it looking, do we need this? Could we reduce this? Do we need to, are all the people that were still on there, do we still need to pay for all those people? Could we change it to this? Are we still gonna be here for that? And you go through and you literally ask, is this a want, a need, or is there a better way that we could spend our money on this? And again, I know it sounds so dumb. Like this, this is not fun.   This is not something that I'm excited to share with you on a podcast, but I'm so excited because the discipline of doing this, the doctor, the reason it came up is because she wants to sign up for AI, ⁓ Pearl or Overjet. Back and forth, we talked about it at length of which one's better. This is why I love our Dr. Mastermind. And it's about $130 a month. And she just like, I'm so sick of these subscriptions. And I'm like, well, go get rid of Netflix or go get rid of one of these things or don't have all the beverages in the   in the refrigerator, maybe just choose one of them. Like there's so many things like, but this is where you look at your list because you have your entire list in front of you. And my office expenses right now, and this is where I look at my credit card. I look at every single thing on there. Right now we have 39 different things that we pay for of monthly subscriptions or annual subscriptions, different things. It's got our insurance policies on there. And then what I can do is I can come in and assess and say, okay, of all these high expenses, like if I need to cut expenses very quickly,   I could look to see, all right, my highest hitters are XYZ. This one's $500, this one's $1,000. Do I still need these? Are we still using them? Is there a cheaper competitor that I could switch to? Where am I at? And all these things. What I love about this is it helps you just look to see where your money's going because at the bottom it has a grand total. And then what's nice is I then can look to see, is this grand total what my CPA is telling me I'm spending every single month? Do they line up?   And if not, where's the discrepancy and where is it? I also can look at future things. if I'm going to be increasing or I'm going to be adding team members or we're going to be looking to add say another subscription or another piece, what is that going to change my monthly amount? And am I okay on my production and collection side to be able to afford it? So many people are like, I talked to my CPA to see if I can afford it. And I want to just say that yes, it's great to have a CPA there. It's also better to know instead of being like a parent child.   if you can spend it. I want my CPA to give me my books, my reconciliation. I want them to talk to me about my tax strategy, but I don't want them to be the ones telling me, can I afford something or can I not? I wanna go to them and say, I know I can afford this. This is what I think. Do you think it's a good idea? Then I'm counseling with them rather than being told. And this goes for all of my executive board. I want to know as much as I possibly can. So that way when I show up, like even financial advisors, even my...   My lawyers, like I do a lot of research before I go into those because I don't want to just blindly follow. I want to actively participate. So we're making the best decisions. I believe they're all in the best interest. I don't believe my CPA telling me to do something or not to do something is the end all be all. I feel like we are great at counseling together. They give me their opinion. I know the numbers. They know the numbers. We know where the business is going. And then my job is to make the best decision for the business and for myself.   So this is where I just really obsessed because right now I'm looking and I'm like, wow, what I'm currently paying based on bringing in some new hires, we're gonna do a $30,000 increase. And I look at that I wonder, is that wise? Is that what I wanna do? Is that what we as a business wanna do? Is that smart for the business? Or is it something like, then I get to sit here and I get to innovate and we get to think of like, what other ideas could we do? That's why I went down the list, because I wanna hire some more people. It's a little premature for these hires.   So I was like, okay, let's go back to the list. Let's look at the list. Like where could I like cut some costs to see, could I free up any cash in other areas or do we need to make different decisions? Or is it like, I need to put a pause on hiring that person for a little while until the business gets to X amount and then we can bring on those different hires. So when you look at this, that's how I do it. I use this spreadsheet. I'm not kidding. I I hold, I can tell you exactly because what's great on Google Sheets is they can literally tell you all the different versions. Okay.   So let's just go back to, I'm going to go, this is embarrassing. I'm going to go to June. Okay, so I'll just go back a few months for you guys. I logged into this spreadsheet of the monthly costs. June 5th, June 10th, June 16th, June 19th, June 24th, June 24th, again, June 25th, July 2nd, multiple times, July 7th, July 8th, July 9th, July 10th, 15th, 16th, 17th, 18th, 24.   The only reason it stopped there is because I went out of town August 3rd, August 6th, August 7th. As you can see, I'm in this spreadsheet almost daily. If not every other day. That's insane. I mean, I can go back to April. I can go back to March, February, January, December, December. I'm in here all the time. November, October of last year. I'm just going down. October. I was in there 10 because that's when I started to do projections. So you better believe I was in there a lot more during that time. October. There's about 20 entries September. So when I tell you this is a tool,   that I have found that works so insanely well. Clients love it. Cause then we're like, our overhead's high. We can go over to our costs and say, why is it high? What is causing this? I'm looking at people's loans that they have and I'm like, do you really use the Seric? Do we need to continue to use this? Are we using all these different like plan Mecca and all these other loans that we have on the practice? Are we still using that? And if so, that's fine. But let's at least know where our money's going.   so then we can make better decisions of do we wanna continue that? And so hopefully, like I said, it's not a fun topic. Like it is, this one, if you can't tell, the passion, the fun, like it's really fun for me to look to say like, okay, where is it? This is where I decided it was time for us to close our headquarters down in Reno. We used to have one, but I was looking for how can I cut costs? Where can I, because for me, I'd rather not spend it on a physical location. I'd rather buy, like spend that money on different softwares that are gonna make us more efficient, being able to hire better employees.   Like I'd rather reallocate those dollars to something that's gonna benefit the company more. And so for you, just feel like this is such a great tool to help you truly know where your money's going, know where you can cut. And like I said, I do this for personal. I'm like, all right, give me all your costs. Give me your credit card. We're gonna look at every single thing. And then like, what could we do differently? I mean, my cell phone, let alone, I used to pay almost a hundred bucks a month for my cell phone. It's now, hold please. I'll tell you the exact amount. Cause I can tell you it's literally right here.   Um, it is a telephone right here, $35 a month. And I used to pay 95, but that was once again, like Verizon got a competitor. have a sister company called visible. I could even get it down to 20, but I didn't want to like drop that far. But we went from 90 to 35 and there was no change or disruption. I watched it for several years. I had people do it, then made the change. Is there a better company out there for X, Y, or Z? Is there a better processing company? And I know again, this seems annoying.   But annually around September, October is when I start to do projections and I start to look at everything. Cause I'm looking at costs. What could I cut? But monthly, daily, I'm looking to see who can I hire? Where can I do things? Change it, adjust it. And what's amazing is when doctors and OMS have this tool available, now you're like, can we afford to hire this person? You can answer with confidence rather than hoping and praying you're going to be able to make it. Just like what I used to do. was like, let's just hope and pray we're going to hire them and hope it works out.   now I can have way more confident decisions. And like, think as a business owner, being able to have confident, like one of the strongest things you need to do as a business owner is be able to make decisions. And I think the second piece to that is being able to make more confident decisions, utilizing tools like this one that I'm sharing with you. So if you want help, reach out, Hello@TheDentalATeam.com. Like I said, I love to put this together for clients. I love to give them the tools and resources to where they can actually be here and know. And also I say if you're here,   Like go get your credit card, list everything out that you're spending money on. Look at your P &L, see if it matches up, see if you can figure it out. And this was something that's been evolved over the course of honestly, probably eight years. I started it when I was really new into the business. I made this myself because I'm like, I don't even know where my money's going. How am I supposed to be able to make decisions? And I could not figure out why my overhead was so high. Now I can tell you exactly this is what we're spending every month. This is why we're spending it. This is what we want to do. This is where we're going. These are the numbers that we need to do.   It just gives you so much confidence, clarity. And so that's why I just love to share it and to help you. ⁓ I believe, like we said in the yes model, you as a person need to know where your vision is. Then we need to have your earnings and your profit where it needs to be. And then we need to figure out the systems and team development to support all of those pieces. And that's what we love. It's what I'm obsessed with. So reach out, ⁓ even if you're like, I don't know. I don't know if I'm a good fit. Let's just have a call. It's literally no commitment, no stress.   just clarity and confidence to get you the momentum that you deserve. So reach out Hello@TheDentalATeam.com. Go fall in love with numbers and spreadsheets. And as always, thanks for listening. I'll catch you next time on the Dental A Team Podcast.  

The DGS Think Tank with Michael Butler and Kurt Bahr- h4 full 1111 Tue, 11 Nov 2025 22:31:36 +0000 o8zuiShCKhA7p0UrimsXUI9dslW2KWvW comedy,religion & spirituality,society & culture,news,government The Dave Glover Show comedy,religion & spirituality,society & culture,news,government The DGS Think Tank with Michael Butler and Kurt Bahr- h4 The Dave Glover Show has been driving St. Louis home for over 20 years. Unafraid to discuss virtually any topic, you'll hear Dave and crew's unique perspective on current events, news and politics, and anything and everything in between. © 2025 Audacy, Inc. Comedy Religion & Spirituality Society & Culture News Government False https://player.amperwavepodcasting.c

Chad and Jordan discuss a recent trade, the lessons we learned, and the lessons we applied.Plus trades!Plus hours of premium content this month!  You can get all the DTT Patreon content for $10 a month at patreon.com/DynastyThinkTank.Follow Chad on Twitter: @chadparsonsNFLFollow Jordan on Twitter: @mcnamaradynasty 

The DGS Think Tank with David Barklage & Jeff Rainford- h4 full 1056 Tue, 04 Nov 2025 22:41:02 +0000 3VGneHjHQYUInqqQNmyfzlfybt0eAV8d comedy,religion & spirituality,society & culture,news,government The Dave Glover Show comedy,religion & spirituality,society & culture,news,government The DGS Think Tank with David Barklage & Jeff Rainford- h4 The Dave Glover Show has been driving St. Louis home for over 20 years. Unafraid to discuss virtually any topic, you'll hear Dave and crew's unique perspective on current events, news and politics, and anything and everything in between. © 2025 Audacy, Inc. Comedy Religion & Spirituality Society & Culture News Government False https://player.amperwavepodcasting

This week Topher and Jeff celebrate the 7 year anniversary of the start of the Hockey Think Tank podcast. We have learned such invaluable lessons over the years from all of the guests we have had on, the organizations we've worked with, and all of our listeners that have reached out. Listen for each of our top 3 lessons of all time. In this episode we talk about: — How resiliency is everything — Surrounding yourself with good people — Finding a way to stay connected to the game throughout life — How this game is worth fighting for and we need to leave it better than we found it AND SO MUCH MORE! Thank you to our title sponsor IceHockeySystems.com, as well as Train-Heroic, Helios Hockey, and Crossbar! And thank you to our AMAZING LISTENERS; We appreciate every listen, download, comment, rating, and share on your social sites! JOIN HTTU TODAY! Follow us: IG: @HockeyThinkTank X (Twitter): @HockeyThinkTank TikTok: @HockeyThinkTank Facebook: TheHockeyThinkTank Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

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